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Exploring health equity in environmental public health practice at national conference

By Dianne Oickle (she/her) on November 17, 2016

Dianne Oickle (she/her), MSc

Knowledge Translation Specialist

Dianne has been with NCCDH since 2014. Formerly a registered dietitian for 26 years, her practice included 16 years of frontline public health nutrition focused mostly on reproductive and child health in rural settings with many diverse clients. As a white settler cis-gendered woman, her passion for meaningful engagement of people with lived expertise of inequities to inform public health priorities drives her motivation. Her work at NCCDH focuses on community engagement, language and terminology of health equity, mental health promotion, 2SLGBTQI+ health, environmental public health, food systems/justice and digital equity. Dianne earned a BSc at St. Francis Xavier University and an MSc at the University of Saskatchewan. 

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“Innovation Beyond Inspection”, the 2016 annual education conference of the Canadian Institute for Public Health Inspectors (CIPHI) was held September 25-28, 2016 in Edmonton, AB.  Co-hosted by the national and Alberta chapters of CIPHI, the event explored traditional areas such as food and water safety along with emerging issues around tattoo conventions, float tanks, aquaponics, and insects as food.  An exciting aspect of this conference was the intentional effort on the part of the organizing committee to integrate themes around health promotion and social determinants of health on each of the three conference days, drawing attention to the integral role that public health inspectors (PHIs) and environmental health officers (EHOs) play in addressing health equity in their communities.

The National Collaborating Centres for Determinants of Health (NCCDH) and Environmental Health (NCCEH) worked with conference organizers to support the integration of health equity themes in the conference. We also collaborated to present two sessions to delegates and release several new resources for environmental public health practitioners. 

A workshop titled “Health Equity Discussions” began with NCCDH exploring the concepts of social determinants of health, health equity/inequity, equality, and the social environment as a focus of public health practice. Participants were encouraged to move away from a “deficit fix” way of thinking and towards a “justice seeking” approach, which recognizes that where there is poverty, it is society that needs fixing, not individuals. This was accompanied by a discussion by Karen Rideout of the British Columbia Centre for Disease Control (BCCDC) of collaborations around food safety and food security issues, and the development of healthy food donation guidelines. The discussion of food security as a contributor to health equity through these two topics provided the opportunity to highlight the importance of ethical considerations (e.g., not treating the under-served as second class recipients of service) and how intersectoral partnership is a key strategy for EHOs to integrate health equity thinking in all aspects of their work.

A world café style session titled “Creating space: Enabling organizational capacity for action on health equity” integrated the work and research experience of two experts from the field. Doug Quibell of the Northern Health Region shared his work with the Partnership for Healthier Communities (P4HC) program. Discussing 22 P4HC Committees across northern British Columbia, cross-sectoral collaborations among public health, municipal, and community partners were noted as key elements to program sustainability. Doug highlighted the factors that contribute to the success of P4HC committees, which included commitment from health authority leadership as well as elected officials and decision makers, presence of coordination structures and a global vision, intersectoral dialogue, skill development, and citizen engagement. Rob Mahabeer, an EHO with Alberta Health Services (AHS), then presented his graduate thesis work on health promoting activities within the context of environmental public health.  Highlighting the fact that there is currently no bridging policy between organizational health promotion/health equity intent and operational EHO practice, his discussion of mandated activities that have unacknowledged health promoting effects (including socioeconomic and cultural impacts) showed that EHOs often have the willingness to use health promotion principles but are not trained in what they are, how to apply, when to apply, or how to account for resources used.  Upcoming initiatives include the development of a health promoting framework for AHS that is currently in the formative stages.

NCCDH and NCCEH released several new resources during the conference to support the role of EHOs in addressing health equity.

• Key resources for environmental public health practitioners to address health equity: A curated list. This list contains resources specific to environmental public health practitioners with respect to their roles in addressing the social determinants of health (SDH) and health equity in consultation, enforcement, and education.
• Toward health equity: Practical actions for public health inspectors. This framework outlines 10 considerations for action by individual practitioners to help them apply the broader concepts of SDH and health equity to their practice, understand how health equity work fits into their own region or organization, and work with others to support health equity. The accompanying user guide identifies three main audiences and outlines potential points of influence for practitioners.

There is a lot of momentum building around the intersection of environmental public health practice and health equity.  And there is willingness on the part of EHOs and their national organization to further explore the issues.  We want to hear from you. Send me your thoughts and ideas, or start a conversation in Health Equity Clicks.